Maternal, perinatal and neonatal health Pregnancy and Childbirth
Conditions
Interventions
The following interventions to be carried out immediately in three randomly selected geographic areas of the municipality and, after the two-year trial period, in the remaining three areas:
1. Materia
Sponsors
CIET Tropical Disease Research Centre (Mexico)
Eligibility
Sex/Gender
Female
Inclusion criteria
Inclusion criteria: The following have been randomised into three geographic areas for immediate intervention and three for delayed intervention: 1. Twenty midwives identified by the baseline survey as having assisted at three or more births in the previous 3 years 2. All women in the baseline sample clusters who give birth or become pregnant during the trial period 3. All adult family members of the above 4. All families of the baseline sample communities where pregnancies or births occur during the trial period 5. Community health managers (gestores) certified by the Red de Promotores de Salud Indigenas Amuzgos, A.C. (Indigenous Amuzgo Health Promoters Network) 6. Medical personnel and support staff of health centres and hospitals serving the municipality of Xochistlahuaca
Exclusion criteria
Exclusion criteria: Does not meet inclusion criteria
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The 2011 follow-up survey will measure the following indicators from the 2008 baseline survey among women who gave birth during the previous three years: 1. Neonatal deaths 2. Number of times women seen by midwife during pregnancy 3. Proportion of births at home attended by midwives 4. Frequency of recourse to midwife in case of pregnancy complications 5. Frequency of recourse to midwife in case of complications with newborns 6. Proportion of women intending to have future births at home 7. Among women who gave birth in health institutions, questions about their treatment including birth position, availability of translators, presence of family members at birth, presence of midwife at birth, bathing in cold water, treatment of the placenta, retention of amulets and how respectful they considered their treatment to have been | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. From survey of women who gave birth in previous three years: 1.1. Prevalence of violent acts toward pregnant women 1.2. Proportion of births without external assistance 2. From survey of husbands, mothers and mothers-in-law: 2.1. Opinion as to whom the woman should consult first when she learns she is pregnant 2.2. Opinion as to who should attend the woman first if she has complications during pregnancy 2.3. Opinion as to who should decide whether to take the woman to the hospital if there are complications during childbirth 2.4. Perception of neighbours' preferences as to who should provide antenatal care 2.5. Perception of neighbours' preferences as to home vs institutional birth 3. From survey of health workers: 3.1. Consistency of criteria for classifying levels of pregnancy risk and referral of high risk pregnancies, complicated births and neonatal emergencies 3.2. Willingness to allow midwives to participate in institutional births and to charge for it 3.3. Proportion of workers who have received any intercultural training All secondary outcomes will be followed-up for three years. | — |
Countries
Mexico
Outcome results
None listed